Provider Demographics
NPI:1407409782
Name:ARIAS, DESIREE ANDREA (CNM)
Entity type:Individual
Prefix:
First Name:DESIREE
Middle Name:ANDREA
Last Name:ARIAS
Suffix:
Gender:F
Credentials:CNM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15296 W REDFIELD RD
Mailing Address - Street 2:
Mailing Address - City:SURPRISE
Mailing Address - State:AZ
Mailing Address - Zip Code:85379-8018
Mailing Address - Country:US
Mailing Address - Phone:623-466-4335
Mailing Address - Fax:
Practice Address - Street 1:14239 W BELL RD STE 210
Practice Address - Street 2:
Practice Address - City:SURPRISE
Practice Address - State:AZ
Practice Address - Zip Code:85374-2471
Practice Address - Country:US
Practice Address - Phone:623-584-0800
Practice Address - Fax:623-584-0312
Is Sole Proprietor?:No
Enumeration Date:2019-07-16
Last Update Date:2019-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ228588367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife